Bones, whether human or animal, can develop defects (e.g., a void or cavity in the bone) that can compromise their structure. These defects can occur due to various reasons, such as osteopenia, degeneration, prior surgery, fractures, bone cysts, or trauma. Additionally, after prior surgery for ligament reconstruction of the knee, a residual implant or graft passage tunnel creates a defect. If the implant or graft fails, revision surgery may first require filling of this defect prior to subsequent implantation.
In another example, in the shoulder, such as rotator cuff surgery, prior suture anchors that pull out or fail can leave a bone void that needs to be filled, otherwise revision surgery is not possible with anchor placement in that location. With disuse osteopenia, cystic degeneration can cause the bone structure to be compromised. In other cases, traumatic injury can create defects in the bone. In osteoporosis, bone quality can be reduced such that primary implant insertion fails due to weakened structure and may require some form of supplementation (such as filling of the defect with a cement like substance) to allow surgery to be completed. These defects in the bone can limit the capacity for various implants or grafts to be secured within the bone. As such, this can lead to situations where the bone may need to be grafted or augmented prior to securing the implant or graft, either immediately or in a staged manner with multiple surgeries.
Regardless of how the defect occurred, various solutions have been explored to fix the defect, but they all lack in one way or another. One problem with the existing method is it does not allow containment of the cement like substance within the bone defect. Often, the material spills over and around the bone defect and causes intrusion into and around the joint and surrounding tissues. Since the cement like substance tends to harden over time, it creates a solid structure into other areas of the body thereby causing crystalline deposits inside the joints. These deposits can be harmful to the body causing several types of medical issues, such as cartilage degeneration, tissue foreign body reaction and pain.
Bone defects vary in shape and size and the defect often contains uneven surfaces. The current methods do not provide a mechanism to contain the cement like substance inside the uneven shaped defect and result in allowing the cement like substance to leak and escape to other parts of the body. The escaped substance causes visualization issues for the surgeon and several medical problems as explained earlier.
Yet another problem with existing solutions is visualization. The current procedures for reconstituting the void in the bone, thereby fixing the defect, require a surgeon to create a working portal and visualizing portal. The working portal is established through an incision made at or around the area requiring surgery (the operative field) and allows the surgeon to perform surgery on the defect using surgical tools through a subsequent portal. The visualizing portal provides visual access to the operative field such that the surgeon can see the area of surgery while performing the surgery. Visualization is critical and key to a good and successful outcome with surgery. Existing methods are unable to deliver the cement like substance to fix bone defects without blocking surgeon's line of sight to the operative field. Since the current methods cannot contain the cement like substance within the defected bone cavity, the excess material either protrudes out of the defected cavity or accidentally gets deposited outside the cavity blocking the surgeon's vision during the procedure.
Bone defects can have various depths, contours, and ruggedness. Although Current methods allow depositing of the cement like substance into the defect, they cannot achieve a thorough penetration of the cement like substance into the interstices of the bone structure. This is largely because pressure needs to be applied in order to achieve a thorough penetration of the cement like substance into the interstices of the bone structure. Since current methods (in arthroscopy) cannot contain the cement like substance within the defected cavity, applying pressure only increases the problem by allowing even more substance to escape from the defect and into other regions of the body.
Thus there is a need for a solution to address the concerns mentioned above.